Good Doctors, Bad Patients: The Construction of Transgender Patients in Medical Textbooks

Abstract

There is a growing consensus that medical schools are insufficiently educating students about transgender care. Drawing on a content analysis of textbooks assigned in top American medical schools, this thesis examines the representation of transgender patients in medical education. Focusing on sections which discuss transgender health and medical treatment, I show that transgender patients are constructed as either conforming to normative and medicalized expectations, or problematized as “bad” patients. While transgender patients are always at risk of being viewed as “bad” patients, physicians are taught that simply adopting an unbiased attitude towards these patients will make them a “good” doctor and result in competent medical care. I argue that these representations contribute to the reproduction of medical uncertainty and provider hesitancy to treat this population. These findings suggest that improving transgender health care likely requires not only more inclusion in the curriculum, but also a re-evaluation of how transgender patients are framed within the medical narrative.